PTSD in Veterans Linked to Dementia in Later Life

A new study sponsored by the U.S. Department of Defense and the National Institute on Aging investigated the relationships between post-traumatic stress disorder (PTSD) and Alzheimer’s disease and other dementias in aging veterans. After researching the trends in these older service members’ mental health over a seven-year time span, the study found that veterans diagnosed with PTSD were nearly twice as likely to develop Alzheimer’s disease or dementia as they age than veterans without PTSD.

Post-traumatic stress disorder (PTSD) is a multifaceted mental illness that has long been attributed to veterans of war. PTSD can cause a range of symptoms including disturbing flashbacks or nightmares of trauma, despondency, fatigue, depression, anxiety, anger, and insomnia. The common symptom of memory loss might indicate that damage to the region of the brain that controls memory, the hippocampus, could be caused by acute stress. Researcher Kristine Yaffe and her team’s study is the first to consider a connection between PTSD and age-related dementias, although it was not clear whether PTSD increases susceptibility for dementia, or if recurring episodes of PTSD are early symptoms of dementia that has not yet been identified.

Through the U.S. Department of Veterans Affairs medical centers, the research team followed 181,093 veterans who were over the age of 55, mostly male, and were not exhibiting signs of dementia. The study began in 1997 and measured the veterans’ mental health progress until 2007. Prior to the trial period, 53,155 of the veterans were already diagnosed with PTSD, while 127,938 veterans were not. After a follow-up measurement in 2000, none of the veterans had been diagnosed with dementia; yet by 2007, 31,107 veterans were newly diagnosed with dementia. The veterans who had PTSD had a 10.6% incident rate of dementia within a seven-year period, while those without PTSD had only a 6.6% incident rate. Furthermore, the veterans with PTSD were 77% more likely to develop dementia than those without it when risk factors related to Alzheimer’s disease were included. The same results were found even after excluding those veterans who had a history of clinical depression, substance abuse, or head injury.

Now that a link between PTSD and late-life dementia has been discovered, the researchers concluded that further research is required to help identify the actual mechanism that triggers dementia in individuals with PTSD to help lower risk. PTSD is a chronic illness that may last for years or can span an entire lifetime. Sometimes individuals with PTSD experience their symptoms in recurring episodes over time. According to the U.S. Department of Veteran Affairs, about 1 in 3 Vietnam veterans, 1 in 10 Gulf War veterans, 6–11% of Afghanistan veterans, and 12–20% of Iraq veterans have PTSD. As many as 12% of veterans of WWII and the Korean War still report symptoms of PTSD today. In the U.S., 5.2 million Americans are believed to experience PTSD in a given year. Furthermore, the Alzheimer’s Association estimates that 5.3 million Americans have Alzheimer’s disease, the most common type of dementia and the sixth leading cause of death in the U.S. An estimated 14% of Americans over the age of 71 have a type of dementia.

Health care services for military personnel have been sharply criticized throughout the Afghanistan and Iraq wars, particularly regarding services provided for substance abuse and mental health. Recently, the General Leonard Wood Army Hospital in Missouri came under scrutiny when a former drug counselor from the hospital filed an official complaint against the hospital’s commander and director of the facility’s drug treatment program. The complaint alleged that the officials were intentionally refusing soldiers drug treatment to help alleviate overcrowding and reduce long waiting lists, which has become a common problem throughout the Army. After an Army internal investigation, the complaint was dismissed, and the drug counselor sought assistance elsewhere.

Prompted by the drug counselor’s concerns, U.S. Senator and Senate Armed Services Committee member Claire McCaskill stepped in and sought legislation to help improve and secure the Army’s Substance Abuse Program. Since McCaskill helped gain passage of the National Defense Authorization Act and initiation of the Army’s Confidential Alcohol Treatment Education Program (CATEP), the Army has announced its realignment of its substance abuse and mental health services for military personnel to not only improve provisions of services but also accessibility and management.

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